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Death Certificate - Shuichi, Otake_1/21/2010ul��tnis�nn�wna �ann umaua u �n uniu:�aenaencs�ua �m uua i ayr uana� � t�i iqusna ia u� 139430 � _��_.:�rw��" .a._.�`,':.•._s-�`G�'�`'�s.F_ J."=£."��` c>...4� .... � .' �� -y..�..-�:3,.�.&t_-'�..M1rS.s� b_....�":_.ir :<•„ � �• ` ' 1.O..0 ' Local No....!.�... i o0aaasiqaw�.�r.n�emo.�nn Shuichi Otake s sa eSmrbNmw u. M•-"n .Tw I 36 c 6vm�5.,hmiowa faew�ncwr. QYa�tSih:.a.n❑ I Oi�OaY�IE .1. M3lr1�ml�lM/��614MGVe9atlMtlMdh Gi6son General Hospital ,z cno,wo,:m..wzocw Princeton u. s..�aa.a�.na.+ Brittney Otake . -� Indiana :ec sn.awew.m 1128 S 200 W INDIANA 3TATE DEPARTMENT OF HEALTH CERTIFICATE OF DEATH w,. � a., Gibson ale � 0730 AM August 31, 2008 r.umaem�uw.mr��r� am+pm�wMasd.o��..�cm,. Ottober 21, 1971 New Ybrk City, NY n Gibson I gQ�� o����mo� �...., o.,...�.,.� o � w. wam�.uveiomwo� +�. w.ca i Supervisor Automobile Manufacturing Princeton 47670 � ��` �" College 6 I Japanese Japanese P_IfMfiNay� '.YChIaU ZJ.'ASV{bao1���1IE6iLA) �v. • m �dasahide Otake �Sonoe�Otake Nakadai a.-�,�. � a� c�a ec ���w�za�sscsscc caa Srittnsy Otake I Wife Iti29 S 20D W, Princeton, IN 47670 zs. w� a otr�;a, ..v.u.au wm� wo�auw��o+.,.a�ca.�r.u..w�...aaa.�r ��.�.�-w. �.tinoa�. o �,�� °o°i°"°E"`Y`" EvansvilleCrematory EvansvillelN ❑ arrss#i '��'�° `°°rfa°°"' " ""'"'°`°'�'° °"° """'"�Colvin Funeral Home, InC. FH93005fi71 "' �"'"°-"'m°'"`°' DQY^ �'� 425 North Main Street, Princeton, IN 47670- FH83005671 :les tC+aw.rJSUw, nctim...n�nY.IGle�w} �%CM,. �;'.��i✓ FD01009940 � Uvu OI DvaN ISw IkWCtiwu Md EaanWlas) D. Fanl. E�Cr.TYFVnOtcvex.r0i;ezso.l:5u'rs.UGOndez:aa-�:xtOVasMCmixaTe:aa•: Ou�o.EneriemimlPwKS lVp�:Yr SxhASCaracRemtFesPZe�YArtXOrVe`er:iarfienLCUntYC'da5noni.'5ThEtido41.0oNaALlrMme �vttONyQxCS:vep� 1.2emf.QCe� n�.nwau3�mw,:sirrk«:�y. Acute Anterior Le�t Ventricular rooer� m�,,.a�;eca���aau�eaco�ax�,R�e.—�.mo�w� a. rivocardial Infarct. ��F: � � s�A:,�,�;��,�,;:ers.i:ar�.�,5,�ro�c�"°�:�aa, e. Acute Thrombosis,Left Comaon Coronaiy Artery. IseA �rtnTelLEr.h�'i�ue(OivaseO�IN'+nTtallNimm Y,� ..+x�Tn �a��ss:e:r.,�mo�.+t:�a c Mi1d Generalized S Severe Coronary Arteriosclerosis. ...... ..�.,.... _< O�n O�s p r.+ Q�+,w. w �z. ���ts.roo.nm oneTOn.rneav.�•... C�+maF:.>ao-d ora�xs�+.a'w.�.r+�++�..ca,.aa.n ❑`tlFwrx.NR��u1Yi:1n::"�5l�:M 6:+ki+_fiMa11lMIItPS�yv �� r ' % � � a � -i� �, ..'- • � 1], eS.-a lmoe M: Lp Cede Of Gr.onCw'y.. � Usa q �t.n: Richard D. Hickrod , Gibson Co. Coroner 425 N. Main St., Princeton, IN 47670 1:. AMICa15iu�5chaROW G. �°�-�'��l'/ �� : . `THISISAN�:ACTCOPYOfiIiEGLRTIfICA7EOFGLAILASIT1iP5C@CNFIIEUPNfi150NRECORDINTiEC � - t", OEPnHTh'.@Nt. LHISI$\OTTOfk"CO�SIDEREDAVHL�OCOPYUNL[SSSEALEOWILNIMEOF=ICIALRA6EU . `- STMIPEO W1N i}IE11 l�H f i 'S;.1WlAlUftE. "�"� SEP 0`� c��� ��ro>>:. ,,.,� �.� ... . . . . . . : . . . �. o�� a � o:.,�v�..+wu+ �S�z-'e pOA���Ry�.m.f �_ Rmtariq WmlEhml l�. tM N Wav' ❑YC ❑W �w. rOw o �a. rrr.�wwcihar.z�r ❑a,<cc:.e. oxs.f oa�Mo�m� u+.o+ro�� ���CwmvO �Y��n I H.lan�axvtv �5 nCn[4O Sept. 8, 2008 I�,. •,m ��r � .�ZOD� OBSONGOUNTY :.�; �� �